It is a general study that each molecule that a researcher discovers takes about 7-8 years to get commercialized and on an average, 3 million dollars is spent on one drug discovery. And still you say that medicines are getting costly. This is a cycle. The costs of factors of production in the field of medicine are increasing day by day and the demand for these services is also increasing due to improving life expectancy. So, the cost of availing medical facilities is increasing and you cannot afford to display an ostrich syndrome. To avoid these costs or to transfer them, you can purchase Health Insurance policies or Mediclaim policies, as they are popularly called.
Health insurance is an insurance policy that covers the medical expenses of the insured person/ persons. It is important to have health insurance as when there is a medical emergency either to oneself or near and dear ones, one goes through lot of physical, mental and financial stress and it is good if at least the financial stress is taken care of up to certain extent. There are various kinds of policies available for different purposes.
Religare Care and Apollo Optima Restore insurance plans
Religare Care and Apollo Optima Restore insurance plans offer the unique benefits. Religare Care offers the recharge option and Apollo Optima Restore has the ‘Restore’ benefit. Let us review & compare the two plans –
|Parameters||Apollo Munich Optima Restore||Religare Care|
|Entry Age||– An individual plan can be taken from the age of 5 years till 65 years. There is no maximum age limit on renewal.– The Family Plan can be taken for family members from age of 91 days if parents are covered.||The minimum age is 91 days and there is no maximum age limit. There are individual plans as well as family plans|
|Sum Assured||It can extend from Rs. 3,00,000 to Rs. 15,00,000.||The sum assured can extend from Rs. 3,00,000 to Rs. 60,00,000.|
|Premium (Sum Assured = Rs. 5,00,000 for 2 Adults and 2 Children)^||Rs. 14,070||Rs. 12,180|
|Health Checkup||Free Health Check up is not available annually.||This plans offers a free medical check up at the time of buying the policy and a yearly check up for adults covered in the plan.|
|Pre Hospitalization and Post Hospitalization.||Pre and Post hospitalization benefits are offered for 60 days and 180 days respectively which is very good.||Pre and Post hospitalization benefits are offered for 30 days and 60 days respectively.|
|Co-Pay||There is no co-pay clause on valid claims.||– There is no co-payment if a person’s age is less than 61 years and buys the policy for the first time.- There is a variant which offers no ‘co-pay’.- People above 61 can buy a policy of sum assured Rs. 3 lakhs or Rs. 4 lakhs and get the No Co-payment’ option|
|Day Care Treatments||Up to 140 day care procedures are covered under the policy.||Expenses of 170 Day care procedures are covered.|
|Hospital Network||They claim to cover 4000 hospitals in over 800 cities||They have a tie-up with more than 3500 hospitals around the country.|
|Multiplier Benefit||The policy holder gets a bonus of 50% of the Basic Sum Insured for every claim free year, maximum up to 100%. In case of claim, bonus will be reduced by 50% of the basic sum insured but this reduction will not reduce original sum assured amount.||The policy holder gets a 10% bonus on no claims every year and the maximum is up to 20%. In a variant, called the Super No claim bonus plan, an increase of 50% is got every subject to a maximum of 100% of the sum insured.|
|Restore versus Recharge Benefits||– It has a Restore benefit feature. The sum assured is restored or refilled during the policy tenure if it gets exhausted.– For example, if you have a policy of Rs. 3,00,000 and it gets used up entirely during a particular year in the policy term, the amount will get restored and can be used again in the same year for a different illness/problem.– If it is a family floater plan, if one person uses the sum assured, and another family member needs it; he/she can use the restore benefit feature.
|– This policy has the ‘Recharge’ option. When the sum assured is utilized, it immediately gets recharged to the original sum assured and can be used for different future illness claims. This can be done once a year.- The advantage over the ‘Restore’ option is that the sum assured gets reinstated immediately and the policy holder does not have to wait till the entire sum assured is claimed.
|Discounts||The policyholder gets a discount of 7.5% on the premium if the policy is bought for two years.||The policyholder gets a discount of 7.5% on the premium if the policy is bought for two years and a discount of 10% if the policy is taken for 3 years.|
|What is not covered/ Limitations||– The restore benefit cannot be used for the same condition/illness for which the sum assured had been used earlier.– There is a waiting period of 3 years for pre-existing diseases to get covered and 2 years for specific conditions like hernia and joint replacement surgeries.– Pregnancy, Dental Treatment, Congenital diseases, Cosmetic surgery, Mental disorders and AIDS and related diseases are not covered.
– Hospitalization due to nuclear attacks, wars, radiation, dug and alcohol abuse is not covered.
|– There is a cap on the room rent.- Pre-existing illnesses are not covered.- Treatment due to pregnancy, dog and alcohol abuse, infertility, wars, strikes, nuclear accidents, attempted suicide and AIDS is not covered.|
|Comments/Conclusion||– The pre and post hospitalization coverage is exhaustive.– The multiplier bonus is also attractive compared to Religare Care.– But the premium is higher.
– From a first glance, the ‘recharge’ option looks better than Optima Restore’s ‘restore’ option.
– This is a good option for health insurance seekers if multiplier bonus, pre-existing illness coverage and pre and post hospitalization coverage are important features to consider.
|– Religare is relatively new in the insurance sector. There is not much data on service and claim settlement ratio.- The recharge option is better than the restore option as the sum assured is reinstated the moment a claim is settled.- Premium is lesser and sum assured can go up to Rs. 60,00,000.
– It is a good policy to buy if the features suit your needs
Read: Review of Apollo Munich Optima Restore
We would like to know which health insurance plan do you have and your reasons for selecting the one you have.